Global Fertility

The total fertility rate has been steadily falling around the world, but rates in sub-Saharan Africa remain high. In Nigeria, the region’s most populous country, the average woman will give birth to six children in her lifetime.
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One in four women in Sub-Saharan Africa uses contraception. Frequently cited reasons for not using contraception include a belief that the woman cannot or will not get pregnant, opposition to contraception for religious or other reasons, and fear of side effects. Globally, there are over 220 million women who do not want to become pregnant and are not using contraception.
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At 1.9 children per woman, the fertility rate in Brazil is among the lowest in Latin America. Experts suggest that the expansion of women’s rights and increased use of contraception are responsible. Popular soap operas that associate small family size with modernity may also play a role.
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In China, where fertility fell dramatically throughout the 1970s and 1980s, the birth rate is now 1.63 children per woman. The decline has resulted in an aging population that will strain families and the government as the costs of elder care go up and the size of the workforce shrinks.
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The population of the United States is also aging, but due to immigration, the size of the workforce is projected to grow steadily throughout the 21st century.
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Global Infertility

Over 100 million heterosexual couples worldwide would like to have children but are physically unable to do so. Infertility affects both women and men. Genetic disorders, infectious and non-infectious diseases, and exposure to certain chemicals are among the causes.
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A band of countries across Central Africa has been termed Africa’s “infertility belt.” Studies suggest fertility problems here often stem from infections that have gone untreated. These include sexually transmitted diseases and infections due to unsafe abortions.
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In low- and middle-income countries, infertility treatment is often unavailable to large segments of society. A 2010 study in Brazil found that three-quarters of its states do not offer infertility services at government health clinics.
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In the United States, more than 7 million women of childbearing age report having used infertility services. The country’s sperm banks, IVF clinics, and surrogacy programs are part of a multibillion-dollar fertility industry.
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Secondary Infertility

Infertility sometimes sets in after a couple has already had one or more children. Termed “secondary infertility,” it can be caused by complications from previous pregnancies and deliveries. The prevalence varies widely across the globe.
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The high rate of secondary infertility in Russia and Eastern Europe may be linked to unsafe abortions. Abortion is a common method of birth control in the region. When poorly performed, the procedure may damage a woman’s reproductive organs.
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The rate of secondary infertility in the world’s most populous country, China, is difficult to estimate. The government’s one-child policy discourages most couples from even attempting to have a second child.
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